The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.
That said, there are products that don’t have FDA approval or clearance, but may help prevent hair loss. For example, shampoos with ketoconazole, a chemical with anti-DHT properties, is widely used to treat fungal infections but has become popular among consumers as a hair loss treatment. It makes sense — research shows that ketoconazole actually has beneficial effects on hair growth (especially for those with seborrheic dermatitis).
The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider “normal” on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.
The good news: Hair transplants don't look like dolls' hair anymore. The bad news: You won't be able to go anywhere to show off your new 'do because you'll be broke. The average recipient of a follicle transplant receives several thousand grafts -- strips of hair removed from bushier parts of the head -- at a cost of several thousand dollars. The cost continues to mount when patients come back for added thickness over the years.
It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).
I always advise clients to allow freshly washed hair to air dry until half dry at least once a week. By blow drying for just 50% of the time, you reduce the impact of heat styling without compromise on finish. Small change big difference over a year. We say, “Go Low Low” – use low heat and low speed, it’s the best way to work with a curl to achieve definition and the best route to a frizz free finish on a sleek straight look. Pick a hair dryer that works harder for you too – beyond just drying. My Infrared PRO hairdryer dries from the inside out, so it locks in moisture to keep that glossy finish, while the speed at which it dries minimizes the disturbance to the follicle and thus keeps frizz at bay too.
Instead, Advanced Hair Studio offers hair loss tablets that inhibit DHT production through naturally occurring ingredients, such as herbs. Our Serenoa 320 capsules and Advanced Hair and Scalp Antioxidant use natural ingredients, including the plant extract Serenoa as well as Fallopia japonica, Zinc, Biotin, Silicon and Ascorbic acid to reduce DHT production and create a healthier scalp.
When hair loss is related to a medication, stopping the drug usually prevents further hair loss, and the hair will eventually grow back. Hair also tends to grow back after most illnesses, radiation therapy, or chemotherapy. Wearing a wig or hat can hide the hair loss until the hair returns. Hair transplants are a more permanent hair-replacement solution.
"The thyroid gland helps to regulate the body's metabolism by controlling the production of proteins and tissue use of oxygen. Any thyroid imbalance can therefore affect hair follicles", Anabel explains. Also, if hypothyroidism is left untreated it may result in anaemia, which - as we've just discussed - is another condition that can impact the hair (or lack of it).
While stories about hats choking off follicles or long hair pulling on the roots may be more folklore, repeat hair trauma like tightly woven hair pulled back and consistent friction can potentially worsen or cause localized hair loss in some individuals. Individuals who pull their hair tightly back in a rubber band can develop a localized hair loss at the front of the scalp.
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Telogen effluvium - occurs mainly due to the body’s reaction to stress, brought about by, illnesses such as cancer, mental and emotional disturbances, medications such as blood thinners, hormonal imbalances, stress during childbirth and so on. In this condition hair thinning occurs on the scalp. The hair usually regrows after the stress period is over.
Sex hormone testing, especially for women and men with hair loss, should include DHT (DiHydroxy Testosterone). DHT is a derivative of the male hormone testosterone. In women, perimenopause and menopause marks a drop in estrogen which leaves hair particularly vulnerable to DHT. Women with PCOS struggling with hirsutism (excessive body hair in women in areas where men typically grown hair including the fat, check, and back ) and male-pattern hair loss should be sure testosterone and DHT are part of their lab testing too. The American Hair Loss Association describes DHT as “the enemy of hair follicles on your head”:
The term "ringworm" or "ringworms" refers to fungal infections that are on the surface of the skin. A physical examination of the affected skin, evaluation of skin scrapings under the microscope, and culture tests can help doctors make the appropriate distinctions. A proper diagnosis is essential to successful treatment. Among the different types of ringworm are the following: tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea faciei, tinea manus, tinea pedis, and tinea unguium.
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.
"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol.
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
In addition to your hairstyle, the processes you use on your hair, whether it’s to add color or texture, can have a detrimental effect. For example, harsh chemicals for bleaching and straightening, along with excess heat, can damage and even kill hair follicles, Burg points out. Additionally, excessive chemical treatments applied directly on the scalp can cause inflammation. “Inflammation can damage the follicle, which in turn to can lead to hair loss,” says Maria Halasz, CEO of évolis Professional. To prevent over-processing, she recommends limiting chemical treatments on the scalp to every four to six weeks. Check out these tips for people who use heat on their hair every day.
There’s no such thing as a drug that’s without side effects completely. However, finasteride isn’t as harmful as some of the other types of medicine on the market. In fact, such a small percentage of men experience side effects at all, making the medicine effective and safe. With that said, there are a few things that you should know about the drug before you start taking it.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
All men and women will be affected by patterned hair loss at some stage in their lives. While the majority of men have developed temporal recession by their mid 20s and noticeable balding by their mid 50s, for most women, hair loss is mild and only occurs later in life. However, when hair loss is premature or severe, it can cause distress. A range of treatments is available to slow or reduce hair loss, and stimulate partial regrowth
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD), alternative therapies may not help hair regrow and many are not supported by medical research. However, other treatments that reportedly improve alopecia areata include Chinese herbs, acupuncture, zinc and vitamin supplements, evening primrose oil and aroma therapy.
Minoxidil (Rogaine) is available over the counter and available in 2%, 4%, and 5% concentrations. It may be something of a nuisance to apply twice daily, but it has been shown to help conserve hair and may even grow some. Minoxidil tends to grow very fine small hairs wherever it is applied. It is important to avoid running the liquid onto the face or neck where it can also grow hair. It is marketed for women at the 2% concentration but may be used in higher strengths as directed by a doctor.
Androgenic alopecia. In this condition, hair loss begins at the crown of the head, the top and center, forming the popular horseshoe shape. Because hair thinning seems to follow a particular path, the condition is also commonly referred to as pattern baldness. It is more common among males than females, and is generally thought to be due to genetics/heredity and the natural aging process (about 40% of men start to have noticeable hair loss in their 30s and lose about 65% of hair by the time they reach 60.).
Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.
Patel said the problem with those treatments is that they have not been subjected to large or head-to-head research. There's great variation in how doctors give the plasma treatments and in laser-based devices, so it's hard for patients to know whether they're getting a proven regimen. Nutrafol seems promising, he said, but he does not think that company-funded research showing its effectiveness has been replicated. He has not recommended it yet.
Just as pregnancy hormone changes can cause hair loss, so can switching or going off birth-control pills. This can also cause telogen effluvium, and it may be more likely if you have a family history of hair loss. The change in the hormonal balance that occurs at menopause may also have the same result. “The androgen (male hormone) receptors on the scalp becoming activated,” explains Mark Hammonds, MD, a dermatologist with Scott & White Clinic in Round Rock, Texas. “The hair follicles will miniaturize and then you start to lose more hair.”
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
See a doctor. While it may be easy to treat hair loss that's caused by stress or other physical or emotional shock, other types, especially those caused by medical conditions, require expert attention. Do not self-medicate. A medical test is necessary to determine the real cause of your hair loss. A medical diagnosis is important in order to rule out other factors that might be the cause of your hair loss. On the surface, it's easy to attribute hair loss to stress or the lack of sleep, but it is highly possible that the hair loss may be caused by an unknown or undetected condition related to hormones or genetics. With the right diagnosis, you'll be able to get the right medication and course of treatment.
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
There is no hard and fast answer. With Regaine Extra Strength results may be seen after 8 weeks. Clinical studies have shown that for Regaine Regular Strength or Regaine Gel for men regrowth can occur as early as 16 weeks. But remember that everyone is different so you need to be patient. Studies suggest that Regaine should be tried for 6-12 months before deciding whether to continue.